title: Attitudes as mediators of the longitudinal association between alcohol advertising and youth drinking.
abstract: OBJECTIVE
  To test the hypothesis that changes in alcohol-related attitudes and expectancies mediate the effect of alcohol advertising on youth drinking.
  
  
  METHODS
  Longitudinal survey with a 9-month interval.
  
  
  METHODS
  Twenty-nine public schools in 3 German states.
  
  
  METHODS
  A total of 2130 sixth- to eighth-grade students (age range, 11-17 years; mean, 12.2 years) who were nondrinkers at baseline.
  
  
  METHODS
  Exposure to alcohol and nonalcohol advertising was measured at baseline with masked images of 17 commercial advertisements with all brand information digitally removed; students indicated contact frequency and brand names.
  
  
  METHODS
  Positive attitudes toward alcohol, current alcohol use, lifetime binge drinking.
  
  
  RESULTS
  A total of 581 of the students (28%) started to drink alcohol during the observation period. Alcohol use initiation was positively related to baseline alcohol advertisement exposure. This effect of alcohol advertisement exposure on alcohol use was partially mediated by a change in alcohol-related attitudes, which explained about 35% of the total effect after controlling for baseline covariates and exposure to other advertising contents. The analysis revealed similar results for binge-drinking initiation.
  
  
  CONCLUSIONS
  More favorable attitudes about alcohol may be one path through which alcohol advertising exerts behavioral influence.
authors.affiliation: Institute for Therapy and Health Research, Harmsstrasse 2, 24114 Kiel, Germany. morgenstern@ift-nord.de
authors.forename: Matthis
authors.initials: M
authors.lastname: Morgenstern
authors.forename: Barbara
authors.initials: B
authors.lastname: Isensee
authors.forename: James D
authors.initials: JD
authors.lastname: Sargent
authors.forename: Reiner
authors.initials: R
authors.lastname: Hanewinkel
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000329:Advertising; D000428:Alcohol Drinking / Q000523:psychology*; D001294:Attitude to Health; D016009:Chi-Square Distribution; D002648:Child; D005260:Female; D005858:Germany; D006801:Humans; D016013:Likelihood Functions; D008137:Longitudinal Studies; D008297:Male; D009042:Motivation; D000297:Psychology, Adolescent; D012919:Social Behavior; D012923:Social Class; D011795:Surveys and Questionnaires